“Why does frostbite cause hyperkalemia?”

Added: 2026-05-27

[00:00:00]Why does frostbite cause hyperkalemia?

[00:00:03]Yeah, it's a bit of a weird question.

[00:00:04]It's odd, but you assume the cares.

[00:00:06]Okay, they ask it. So, this is what's going to go down. They're going to tell you that there's a 46-year-old alcoholic who was found out in the snow and he was brought in the hospital. They're going to show you a picture of his feet and they're red and they want to know what electrolyte we're most worried about, which disturbance. The answer's going to be hyperkalemia.

[00:00:27]Now, there's a few answers here.

[00:00:30]The first is and I I could ask you watching this, do you know what's going to cause that?

[00:00:36]The high potassium.

[00:00:39]So, the first is simply if you have necrotic tissue and you're rewarming it, it can lead to the release of potassium directly into the blood from those necrotic cells.

[00:00:50]Okay, that's more of a simple mechanism.

[00:00:52]The second is you can sometimes get rhabdomyolysis. You have muscle damage.

[00:00:59]Okay? And rhabdomyolysis is going to release what into the blood apart from let's say potassium from the dead cells.

[00:01:08]Myoglobin, right? And myoglobin is nephrotoxic, causes acute tubular necrosis, doesn't it? And acute renal failure, potassium always goes up. So, it's more and in addition, there's susceptibility in alcoholics. You have to know that for rhabdo.

[00:01:25]So, we sort of have a situation where we have dead necrotic cells that are releasing potassium in the blood, but also rhabdomyolysis risk with frostbite, especially in the context of alcoholism, and that can lead to acute renal failure due to ATN from the myoglobin and potassium goes up and we do an ECG to check for arrhythmia.